More Insurers Quit Obamacare

Comment: In yet another “victory” for the most-hated American law since King George’s Stamp Act drove Americans to armed revolution, Obamacare continues to send insurers scurrying, wounded and bleeding money, seeking shelter in the hills of Tennessee, and on up to the wintry wilderness at Lake Michigan’s northern Indiana shore.

(Note to Readers: while OCTS is not predicting a flotilla of insurance boat people refugees fleeing oppression at this time, departing the United States from northern Indiana, across Lake Michigan, you might want to talk to your investment professional about buying stock in inflatable rubber boats.) (And don’t forget to buy one for yourself, too, just in case you need health care.)

“Tennessee’s biggest health insurer is dropping its participation in the Affordable Care Act health exchange next year in the state’s three biggest markets, cutting coverage of the 214,000 persons now enrolled in one of the so-called ObamaCare exchange plans by more than half.”

“BlueCross BlueShield of Tennessee announced today that it will be withdrawing its ACA exchange plans in 2017 in the Memphis, Nashville and Knoxville markets to help limit its exposure to what has cost the Chattanooga-based health insurer nearly $500 million in losses in the past three years.” [1]

———-

“Indiana University Health Plans, the insurance arm of the IU Health provider system, will not offer plans on the state’s Affordable Care Act marketplace in 2017, the company said Monday.” [2]

[1] BlueCross eliminates Obamacare coverage in Tennessee’s biggest markets
September 26th, 2016 by Dave Flessner

[2] IU Health Plans leaving Indiana’s ACA exchange,
By Bob Herman | September 26, 2016

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UPDATE – Sicko: Obamacare is Warping the National Psyche

I call tonight’s report ‘Sicko – Obamacare is Warping the National Psyche’.  Is it possible to make yourself sick in the head?  The Obamacare news this week suggests the answer is yes.

Let’s start with spending.  The nation had a balanced budget for most of its history, outside of war-time, until about 30 years ago.  We’ve been running chronic deficits ever since.  Once you cross the line and convince yourself you can spend money you don’t have, it becomes easier to start crossing other lines.

I’ve mentioned Medicaid mission creep on previous webinars.  There’s now an entire cottage industry devoted to misusing Medicaid to pay for things like housing, utility bills, and other things way beyond healthcare. Devotees call it ‘social determinants of health’ and they are busy preparing the ground for new demands for ever-higher social spending through the Medicaid program.  Just put in the hashtag #SDOH on Twitter and you can see these busy beavers at work.

Then there was the story this week about the proposal to raise the minimum wage to $15 an hour in all Medicaid expansion states.  This  would shift some Medicaid beneficiaries from the regular federal match rate – about 50 or 60 percent – to the elevated Medicaid expansion match rate  – currently 100 percent, but falling to 90 percent over the next few years.  Get it?  We have to have a higher minimum wage so we can pull down more free money from Washington.  Let me suggest to you that it’s pathological to sit around dreaming up schemes like this instead of figuring out how to create prosperity, and it all starts with the wrong-headed notion that the deficit doesn’t matter and money grows on Washington cherry trees.

The Obamacare news this week also contained more than its usual share of flim-flam, deception, and bribery.  But what would you expect from a law born of flim-flam, deception and bribery?  CMS is misusing taxpayer information for a new marketing campaign to target people who pay the individual mandate, trying to get them to buy Obamacare policies, instead.  Next, HHS tried to hide a report showing that Medicaid expansion under Obamacare is causing Medicaid fraud to go up sharply.  Next, many taxpayers are failing to submit the proper forms to reconcile their actual wages to the tax credits they receive under Obamacare, but the IRS gives them tax credits the next year, anyway.  The bribe money just keeps flowing.  Finally, CMS told the remaining insurers who are still left in the Obamacare exchanges that the government will go easy on them when it comes to consumer complaints, such as enrollment errors.  The insurers are being handed a crutch, all in the name of propping up Obamacare.

Connect the dots and what do you get?  Our thinking is getting more and more twisted as a country.  Another reason why I say Obamacare is a cancer, and must be ripped out root and branch.

Links

#SDOH Industry burrowing away; leveraging Medicaid to clamor for more spending in other programs
http://www.commonwealthfund.org/publications/in-brief/2016/sep/states-influences-medicaid-investment

Latest Medicaid expansion gimmick – raise the minimum wage and more will qualify for higher federal match
http://www.kentucky.com/opinion/editorials/article102584717.html

CMS misusing taxpayer info to target mandate payers in Obamacare marketing campaign
https://majoritywhip14.congressnewsletter.net/mail/util.cfm?gpiv=2100138243.4006.249&gen=1

HHS hides report suggesting Medicaid expansion cause of stunning rise in Medicaid fraud.
http://www.forbes.com/sites/theapothecary/2016/09/18/obamacare-medicaid-expansion-a-lot-of-spending-of-little-value/#6821dfd95263

Taxpayers failing to reconcile ACA credits to wages; IRS spits out subsidies anyway. #RubeGoldbergsRevenge
http://www.forbes.com/sites/theapothecary/2016/09/21/11-billion-in-missing-obamacare-subsidies-from-mass-tax-noncompliance/2/#cb1871273462

CMS hands remaining insurers a crutch, signaling it will go easy on consumer complaints (enrollment errors, etc.)
http://www.modernhealthcare.com/article/20160921/NEWS/160929983/aca-plans-that-see-2017-enrollment-surge-may-avoid-enforcement-over

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Top Tweets – By Hook or by Crook

People may not understand healthcare policy, but they understand wrong-doing.  The Obamacare news this week starts with flim-flam, deception, and bribery.  But what else would you expect from a law born of flim-flam, deception, and bribery?

CMS misusing taxpayer info to target mandate payers in Obamacare marketing campaign
https://majoritywhip14.congressnewsletter.net/mail/util.cfm?gpiv=2100138243.4006.249&gen=1

HHS hides report suggesting Medicaid expansion cause of stunning rise in Medicaid fraud.
http://www.forbes.com/sites/theapothecary/2016/09/18/obamacare-medicaid-expansion-a-lot-of-spending-of-little-value/#6821dfd95263

Taxpayers failing to reconcile ACA credits to wages; IRS spits out subsidies anyway. #RubeGoldbergsRevenge
http://www.forbes.com/sites/theapothecary/2016/09/21/11-billion-in-missing-obamacare-subsidies-from-mass-tax-noncompliance/2/#cb1871273462

CMS hands remaining insurers a crutch, signaling it will go easy on consumer complaints (enrollment errors, etc.)
http://www.modernhealthcare.com/article/20160921/NEWS/160929983/aca-plans-that-see-2017-enrollment-surge-may-avoid-enforcement-over

“ObamaCare Individual Mandate Fine Hit 8 Million People This Year”
http://www.investors.com/news/obamacare-individual-mandate-fine-hit-8-million-people-in-2016/

#PremiumPain #61 – Colorado Obamacare rates jump ave 20%
http://www.denverpost.com/2016/09/20/colorado-health-insurance-rates-2017-individual-buyers/

Obamacare plans have 34% fewer providers in network than off-exchange plans (‘But it’s better!!!’ Sure.)
http://freebeacon.com/issues/audit-obamacare-enrollees-trouble-affording-accessing-care/?utm_source=Freedom+Mail&utm_campaign=705ae3717c-WFB_Weekend_Beacon_09_17_169_16_2016&utm_medium=email&utm_term=0_b5e6e0e9ea-705ae3717c-45628225

ACA will depress wages for high-skilled workers by 1.3%, low-income workers by 3%.
http://www.forbes.com/sites/michaelcannon/2016/09/16/new-survey-suggests-obamacare-killing-jobs/#532ca65b5ea6

Medicaid expansion drags down economy; full expansion would ding activity $174B, destroy 200,000 jobs
http://www.forbes.com/sites/theapothecary/2016/09/18/obamacare-medicaid-expansion-a-lot-of-spending-of-little-value/#6821dfd95263

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UPDATE – Public Option Has Got Legs

I’ve been surprised at how the public option has stayed in the news since the President wrote in favor of it in the American Medical Association journal in July.  It’s got legs.  Hillary Clinton supports a public option.  This week, it was announced that 33 Democratic senators – including Harry Reid and Chuck Schumer, joined by the independent socialist Bernie Sanders – also support a public option.

Supporters of the public option say it is necessary because so many parts of the country are down to one insurer in the Obamacare exchanges.  A public option would cut prices and boost competition, they say.  They have a website – WeWantAPublicOption.com – and point to polls saying a majority of the American people want it, as well as a CBO study from 2013 saying a public option would lower the deficit.

Of course, we know that a public option would only be able to cut prices because it would be subsidized one way or another.  This would drive the remaining insurers out of business very quickly and the debate over single-payer would be upon us.

There’s another scenario within the realm of possibility. It’s getting to be crunch time for Obamacare.  It can’t go on the way it is, that’s pretty evident.  Whoever wins the White House, suppose the public option is put forward in Congress as the way to keep and fix Obamacare.  Suppose also, enough Republicans are not on board with repealing Obamacare outright, but are willing to make a deal.  Suppose the deal offered is this: we get rid of the individual mandate, the employer mandate, and lots of other bad stuff in Obamacare in exchange for keeping Obamacare and instituting the public option.  Such a deal would be very tempting to lots of Republicans.  Obamacare stays but gets re-branded with a new name, the way states have been re-branding Common Core to fool the public into keeping it.

Even if the Republicans hold the Senate, I wonder whether there are enough Republicans in both chambers willing to stand up to stop a deal like this.  I can see the Republicans caving, can’t you?

Under this scenario, we would certainly have our work cut out for us.  We would have to convince the country that keeping any part of Obamacare, or whatever the reshuffling gets called, is the wrong way to go, then convince people that single-payer is not the answer, either.

Finally, let me mention that one of our tweets zoomed up in the first hour it appeared, to become our most popular tweet in the entire last month.

Here it is: Medicaid expansion is a classic third-party payer problem: state politicians feel free to overconsume because someone else is paying.

I guess enough people are familiar with the third-party payer problem in insurance to get the analogy immediately.  Our tweet is intoxicating; use it responsibly.

Background

http://thehill.com/policy/healthcare/296365-merkley-33-senate-dems-now-back-obamacare-public-option

http://www.washingtonexaminer.com/liberal-forces-push-for-public-option-as-insurers-bail-out-of-obamacare/article/2602048

 

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Top Tweets – Still Cockamamie After All These Years

There is more wrong-headed thinking packed into every square inch of Obamacare than anything else on the planet. From just last week’s news:

“Study Finds Illinois Emergency Room Visits Surged After Obamacare”
http://www.skylinenewspaper.com/study-finds-illinois-emergency-room-visits-surged-after-obamacare/

ACA “makes private practice a financially infeasible option for thousands of doctors.” It’s deliberate.
http://www.forbes.com/sites/realspin/2016/09/07/why-private-practice-is-dying/#65f823381473

Washington’s dream of running all medical care thru #Hospitrosses – higher costs and worse outcomes
http://www.forbes.com/sites/realspin/2016/09/07/why-private-practice-is-dying/#65f823381473

New GAO sting finds Healthcare.gov still vulnerable to fraud
https://morningconsult.com/alert/gop-touts-gao-report-finding-aca-marketplace-vulnerable-to-fraud/

“All 2015 Risk Corridor Funding To Go Toward 2014 Shortfall” #StupidityOfTheAmericanMastermind
https://insidehealthpolicy.com/daily-news/cms-all-2015-risk-corridor-funding-go-toward-2014-shortfall

States misusing federal grants and Medicaid money to keep Obamacare exchanges afloat
http://thehill.com/policy/healthcare/295654-gops-obamacare-probe-predicts-collapse-of-state-exchanges

“55% of doctors in major metropolitan areas refuse to take new Medicaid patients”
https://www.peoplespunditdaily.com/policy/2016/09/11/ticking-time-bomb-medicaid/

Totally insane “Hill Dems Push To Open CA’s Obamacare Exchange To Undocumented Immigrants”
http://talkingpointsmemo.com/dc/hill-dems-push-to-allow-undocmented-immigrants-to-buy-health-care-in-california

Another Obamacare ACO bites the dust; “financial uncertainties”, “unrealistic”. #StupidityOfTheAmericanMastermind
http://www.seattletimes.com/nation-world/health-law-model-drops-out-of-obamacare-program/

#StupidGovernment keeps underestimating cost of Obamacare Medicaid expansion
http://mercatus.org/publication/aca-worsened-medicaid-structural-problems

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UPDATE – Bad Week for Medicaid Expansion

It was a bad week for Medicaid expansion. I’ll bring you up to date on that and the county in Arizona that was losing its only insurer, as well as the Obamacare innovation center I last mentioned on this webinar some months ago.

Kasich’s Kalamity – his pen-and-a-phone Obamacare Medicaid expansion – continues to go off the rails in Ohio.  The feds rejected his request for a waiver to charge all Medicaid recipients a small premium regardless of income.  This means that the hole in Ohio’s state budget is going to be $1 billion bigger than it would have been under the waiver Kasich wanted.  Good luck, John, finding a billion dollars lying around somewhere.  And other states, don’t miss the lesson here – expand Medicaid and Washington gets to tell you what to do, even more than it already does.

A study came out this week showing that Medicaid expansion has reduced employment in the states that adopted it.  It seems a lot of people in those states heeded Nancy Pelosi’s advice after Obamacare was passed, and took up the violin.  In other Medicaid news, the total amount of improper payments in the Medicaid program has surpassed ONE TRILLION DOLLARS – that’s trillion with a ‘t’.  While it includes other things, there’s a lot of fraud in that number.  And the problem is getting worse, the numbers show.  CBO says the cost of the Obamacare Medicaid expansion will be $64 billion this year.  Three weeks ago, the Truth Squad’s report included a chart showing that Medicaid expansion accounts for one-tenth of the yearly federal budget deficit.  Every dollar spent on Medicaid expansion goes straight to the national debt.  Do you think future generations will thank us, or curse us?

Moving on, Pinal County in Arizona is not going to be without an Obamacare insurer after all.  Blue Cross Blue Shield reversed course and will now stay in the Obamacare exchange for that county.  Before you get too excited, Blue Cross jacked up its rates 50 percent and dropped out of a different county in Arizona.  I would love to have been a fly on the wall when the decision to reverse course was made.  What are the odds, do you think, there isn’t a dirty deal in there, somewhere?

After being out of the news for months, the Center for Medicare and Medicaid Innovation was the subject of three stories last week.  CMMI is a creature of Obamacare that is supposed to look at ways to save money in the Medicare and Medicaid programs.  CMMI is experimenting with reducing reimbursements to providers for chemotherapy.  Can you say – rationing?  CMMI is supposed to limit itself to pilot projects, but it has one pilot going that covers 75 percent of the country.  It is forcing providers to be its guinea pigs, instead of asking for volunteers.  It is supposed to wait for the results of its experiments, but is implementing final changes before the results are in.  Worst of all, it is bypassing Congress by running its experiments indefinitely as de facto programs, instead of bringing them to an end.  Critics have observed this breaches constitutional separation of powers.  I’ll keep my eye on CMMI and report back to you.  I have a feeling CMMI is going to become increasingly controversial over time.

In conclusion, I will toot the healthcare working group’s horn just a bit.  We received our first bit of favorable publicity.  Our friend Phil Kerpen at American Commitment wrote an article recently defending Tea Party Patriots against the attack in Politico lumping TPP in with various scamPACs that billed themselves as Tea Party, but really just bilked people out of their money.  In the article, Phil wrote  that TPP’s healthcare working group has never flagged in its efforts to stop insurance company bailouts, repeal Obamacare, and adopt free-market reforms.  The working group thanks Tea Party Patriots for believing in us and giving us the opportunity to reach far more people with our message than we could by ourselves.

Links

Kasich’s reform package goes down in flames; his Medicaid expansion guarantees state budget woes ahead
https://morningconsult.com/alert/administration-rejects-ohios-plan-overhaul-medicaid/

Study: Medicaid expansion reduced employment in the many states that participated in it
http://www.cnsnews.com/commentary/hans-bader/obamacare-reduced-employment-and-shrank-economy

Medicaid improper payment total hits ONE TRILLION DOLLARS; problem getting worse
http://www.mcknights.com/news/cms-outlines-solutions-for-pervasive-improper-medicaid-payments/article/519783/

CBO: price tag for Medicaid expansion this year is $64 billion. Taxpayers on the hook.
http://blog.independent.org/2016/09/06/medicaid-expansion-and-obamacare-premiums/

Obamacare’s Medicaid expansion already accounts for more than one-tenth of the entire federal budget deficit.

BCBS to cover insurerless Az county, but jacks up rates 50% and drops a different county
http://www.cnbc.com/2016/09/07/arizonas-blue-cross-reverses-obamacare-exit.html

CMMI runs amok: reducing payments for chemo, running demo covering 75% of the country, bypassing testing.
http://www.nationalreview.com/article/439752/obamacare-executive-overreach-congress-investigates-cmmi

ACA innovation center CMMI circumvents Congress w/mandatory participation in ‘experiments’ that run indefinitely
https://morningconsult.com/2016/09/07/lawmakers-grapple-hhs-efforts-lower-costs/

Obamacare innovation center CMMI threatens constitutional separation of powers; abuse of ‘demonstrations’ cited
http://www.rollcall.com/news/opinion/obamacare-agency-escapes-congressional-oversight

OCTS ‘has never flagged in efforts to stop ins co. bailouts, repeal ACA, adopt free-market reforms. Thx @kerpen
https://www.conservativereview.com/commentary/2016/09/how-a-grassroots-game-changer-rose-out-of-the-tea-party-movement

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Top Tweets – Bad Week for Medicaid Expansion

Study: Medicaid expansion reduced employment in the many states that participated in it
http://www.cnsnews.com/commentary/hans-bader/obamacare-reduced-employment-and-shrank-economy

Kasich’s reform package goes down in flames; his Medicaid expansion guarantees state budget woes ahead
https://morningconsult.com/alert/administration-rejects-ohios-plan-overhaul-medicaid/

Medicaid improper payment total hits ONE TRILLION DOLLARS; problem getting worse
http://www.mcknights.com/news/cms-outlines-solutions-for-pervasive-improper-medicaid-payments/article/519783/

CBO: price tag for Medicaid expansion this year is $64 billion. Taxpayers on the hook.
http://blog.independent.org/2016/09/06/medicaid-expansion-and-obamacare-premiums/

BCBS to cover insurerless Az county, but jacks up rates 50% and drops a different county
http://www.cnbc.com/2016/09/07/arizonas-blue-cross-reverses-obamacare-exit.html

Maine co-op leaves New Hampshire market; having financial issues, claims higher than expected
https://morningconsult.com/alert/maine-insurance-co-op-pull-nh-market/

Including off-exchange, “About half the individual health insurance market is subsidized and half is not.”
http://healthpolicyandmarket.blogspot.com/2016/09/detailed-obamacare-blue-cross.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+HealthCarePolicyAndMarketplaceBlog+%28Health+Care+Policy+and+Marketplace+Blog%29

CMMI runs amok: reducing payments for chemo, running demo covering 75% of the country, bypassing testing.
http://www.nationalreview.com/article/439752/obamacare-executive-overreach-congress-investigates-cmmi

“Gallup Poll: More Than Half of Americans Disapprove of Obamacare”; more say it has hurt them
https://morningconsult.com/alert/gallup-poll-half-americans-disapprove-obamacare/

‘You’ll save $2,500’. That’s what you sold us. That’s what you promised. That’s what you’re responsible for. And, no, we won’t forget.

 

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UPDATE – Socialism’s Road to Ruin: A Look at Why Obamacare Does Not and Cannot Ever Work

 

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Obamacare’s Meltdown — 2017 RATE SHOCK Round Up

Comment: New rate approvals are dribbling in for 2017.  We thought you might enjoy seeing our collection of “Obamacare savings” reports thus far. And don’t miss our #PremiumPain series on Twitter.

Update, 9/9/2016
WA – “Insurers selling plans on the Exchange were given an average approved rate increase of 13.1 percent
http://stateofreform.com/featured/2016/09/washington-exchange-approves-46-plans-7-carriers/

MD – “The cost of health insurance plans offered under the Affordable Care Act (Obamacare)” will jump 20 percent or more next year under rates to be announced Friday by Maryland regulators.”
http://www.baltimoresun.com/health/bs-hs-insurance-rate-increases-20160909-story.html

Posted 9/6/2016:
CT – “averaging nearly 25 percent for individuals”
http://ctmirror.org/2016/09/02/ct-health-insurance-rates-to-rise-sharply-in-2017/

MN – “The Dayton Administration announced skyrocketing cost increases of anywhere from 47% to 108% for Minnesotans who buy their own health insurance for 2017.”
http://alphanewsmn.com/mn-healthcare-system-in-crisis/

FL – “Florida’s Obamacare premiums to rise average 19 percent in 2017, state says”
http://www.miamiherald.com/news/health-care/article99562272.html

TN – “Cigna asked for and received an average 46.3 percent increase, Humana asked for and received an average 44.3 percent increase. BlueCross BlueShield of Tennessee, which did not refile its request, asked for and received a 62 percent increase.”
“2017, 57 of Tennessee’s 95 counties will have only one choice: BlueCross BlueShield of Tennessee.”
http://www.tennessean.com/story/money/industries/health-care/2016/08/23/insurers-get-approval-for-2017-obamacare-rates/89196762/

CA – COVEREDCA average rates to rise 13.2%
https://www.internethealthmanagement.com/2016/08/11/covered-california-ups-health-insurance-prices-double-digits/

NY – Individual market, 16.6% 2017
http://www.dfs.ny.gov/about/press/pr1608051.htm
http://www.dailyfreeman.com/general-news/20160805/new-york-state-regulators-ok-health-insurance-rate-hikes-for-2017
http://www.healthcaredive.com/news/moving-on-up-new-york-releases-approved-health-insurance-rates-for-2017/423972/

MI – Affordable Care Act rates may jump 17.3% in Michigan
http://www.freep.com/story/money/business/michigan/2016/07/30/obamacare-rates-affordable-care-act/87623260/

OR – 9.8% to 32%
“In the individual market, the division’s final rate decisions range from an average rate increase of 9.8 percent to an average rate increase of 32 percent, depending on the insurance company.”
http://www.statesmanjournal.com/story/news/2016/06/30/oregon-announces-health-insurance-rate-decisions/86579348/

OK – Says it has no authority to review rate requests, since this conflicts with a 2010 change to OK constitution prohibiting laws compelling health plans
http://www.insurancejournal.com/news/southcentral/2016/05/26/410072.htm
“Blue Cross and Blue Shield of Oklahoma — the only confirmed healthcare.gov participant for next year — filed increases ranging from 49.77 percent to 51.65 percent on three different plans.”
http://newsok.com/article/5501462

TX – BCBS of Texas seeks 58% hikes for 2017
http://www.cbsnews.com/news/problems-for-obamacare-largest-texas-insurer-asks-big-price-hike/

We note that the Obamacare zombies who had, until now, boasted of their unAffordable Act’s supposed “savings” and “control” of health care prices, have changed tactics.

The new line they are selling is that the unAffordable Act’s catastrophic failure (and the complete implosion of their snake-oil sales affordability narrative) doesn’t matter, because the taxpayer pays for it.

(Given that Obamacare has failed catastrophically, we feel this would be a great time to bring back true catastrophic insurance, don’t you? See our proposal here and help us help consumers!)

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Thanks Obamacare! — Household Health Care Spending Soars

Comment: Cato expert Daniel J. Mitchell explains why the Affordable Carp Act’s main mechanism, as predicted, has not made care more affordable, but has had quite the opposite effect.

“Simply stated, doctors, hospitals, and other providers have very little market-based incentive to control costs and be efficient because they know that the overwhelming majority of consumers won’t care because they are buying care with other people’s money.”

“To get this point across, I sometimes ask audiences how their behavior would change if I told them I would pay 89 percent of their dinner bill on Friday night. Would they be more likely to eat at McDonald’s or a fancy steakhouse? The answer is obvious (or should be obvious) since they are in box 2 of Milton Friedman’s matrix.”

“So why, then, would anybody think that Obamacare – a program that was designed to expand third-party payer – was going to control costs?”

Another Grim Reminder that Obamacare Has Made Healthcare More Expensive

Daniel J. Mitchell

  Tuesday, August 30, 2016
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